2: Reflex Nephropathy Flashcards
Define reflux nephropathy
Chronic pyelonephritis secondary to vesico-ureteric reflux. Repeated infections causes long-term scarring and CKD = termed reflux nephropathy
What is the commonest cause of chronic pyelonephritis `
Reflux nephropathy
In what population is reflux nephropathy more common
Children
What causes reflux nephropathy
Predominantly vesicle-urteric reflux (VUR).
Can also be caused by incomplete bladder emptying or obstruction.
What % of UTIs in children is secondary to vesico-ureteric reflux
50
What is Grade I VUR
- Reflux into ureters only
What is Grade II VUR
- Reflux into ureter and renal pelvis
What is Grade III VUR
- Reflux into ureter and renal pelvis, with dilation of renal pelvis
What is Grade IV VUR
- Reflux into ureter and renal pelvis, with dilation of renal pelvis and ureter
What is Grade V VUR
- Gross dilation. Tortuous ureter
What should children with UTIs be investigated for
Vesico-urteric reflux (VUR)
When are adults investigated for vesico-urteric reflux
CKD
Unexplained HTN
Mild proteinuria (<1g/day)
What investigation is ordered to investigate VUR in children under 6 months
micturating cystourethrogram (MCUG)
What investigation is ordered to investigate VUR in children over 6 months
MAG3 scan
How are adults with reflux nephropathy managed
Aim to treat infections
Control BP
